Single-allergen Sublingual Immunotherapy versus Multi-allergen Subcutaneous Immunotherapy for Children with Allergic Rhinitis

It has always been controversial whether a single allergen performs better than multiple allergens in polysensitized patients during the allergen-specific immunotherapy. This study aimed to examine the clinical efficacy of single-allergen sublingual immunotherapy(SLIT) versus multi-allergen subcutaneous immunotherapy(SCIT) and to discover the change of the biomarker IL-4 after 1-year immunotherapy in polysensitized children aged 6–13 years with allergic rhinitis(AR) induced by house dust mites(HDMs). The AR polysensitized children(n=78) were randomly divided into two groups: SLIT group and SCIT group. Patients in the SLIT group sublingually received a single HDM extract and those in the SCIT group were subcutaneously given multiple-allergen extracts(HDM in combination with other clinically relevant allergen extracts). Before and 1 year after the allergen-specific immunotherapy(ASIT), the total nasal symptom scores(TNSS), total medication scores(TMS) and IL-4 levels in peripheral blood mononuclear cells(PBMCs) were compared respectively between the two groups. The results showed that the TNSS were greatly improved, and the TMS and IL-4 levels were significantly decreased after 1-year ASIT in both groups(SLIT group: P<0.001; SCIT group: P<0.001). There were no significant differences in any outcome measures between the two groups(for TNSS: P>0.05; for TMS: P>0.05; for IL-4 levels: P>0.05). It was concluded that the clinical efficacy of single-allergen SLIT is comparable with that of multi-allergen SCIT in 6–13-year-old children with HDM-induced AR.

Efficacy Analysis of Glucocorticoids in the Treatment of Allergic Purpura in Tibetan Children

Background: Henoch Schonlein Purpura (HSP) is a common immune-related allergic disease in children. It is very important to understand the clinical features of this disease for doctors. Objective: To explore the clinical efficacy of glucocorticoids in the treatment of HSP in Tibetan children at high altitude, and to analyze the possible causes of HSP in children at high altitude. The risk factors of the disease provide a reference for the treatment of HSP in children in high altitude areas. Methods: Selecting January 2015 to November 2020, 88 children diagnosed with Henoch-Schonlein Purpura in the outpatient and inpatient departments of the People’s Hospital of Bomi County, Tibet Autonomous Region were the subjects of the study. Its gender, age of onset, season of onset, predisposing factors, allergy history, first symptoms, clinical manifestations, laboratory examinations, etc., perform retrospective analysis. Results: Among 88 children with allergic purpura, 55 were boys, accounting for 62.5%, and 33 were girls, accounting for 37.5%. Men have more cases than women. All have clinical manifestations of purpura of the skin, among which 35 cases have obvious triggers, of which the above there were 26 cases of respiratory infections, 6 cases of dietary factors, and 3 cases of contact with allergic substances. Simple skin type: 18 cases, accounting for 20.45%;Abdominal type: 6 cases, accounting for 6.82%;2 male cases, accounting for 33.33%;4 female cases, accounting for 66.67%;Articular type: 8 cases, accounting for 33.33%;Renal type: 2 cases, accounting for 2.27%;54 cases of mixed type, accounting for 61.36%. After glucocorticoids, the rashes disappeared, no any adverse reactions. Conclusion: Allergic purpura in children is more common in school-age children, and upper respiratory tract infection is the main predisposing factor. Skin purpura is the main clinical manifestation, often associated with lower extremity joint swelling and pain. There is no significant difference in the efficacy and course of the disease between intravenous and oral treatment. Therefore, clinicians should strictly grasp the indications of glucocorticoids to reduce the occurrence of complications.

Comparison of Allergic Rhinitis and Bronchial Asthma Impacts on Tympanometric Parameters in Children at Kano, Nigeria

Background: Allergic rhinitis (AR) is a multifocal IgE-mediated type I hypersensitivity reaction that affects sino-nasal mucosa and is characterized by excessive sneezing, watery rhinorrhea, nasal itching, nasal stuffiness and eyes itching. Bronchial asthma (BA) is one of the common childhood diseases that affects the respiratory system characterized by recurrent cough, wheezing, chest tightness and difficulty with breathing. The two conditions are different manifestations of allergic disease of the airway;the composition of the inflammatory substrate in the mucosa of allergic patients is similar to the late-phase allergic response seen elsewhere in the respiratory tract, such as in bronchial asthma. Aim: The aim was to compare the impacts of allergic rhinitis and bronchial asthma on tympanometric parameters in children. Patients & Methods: This is a hospital based comparative cross-sectional study. Two groups of participants aged 4 - 12 years, one group with documented clinical diagnosis of allergic rhinitis and the other group with documented clinical diagnosis of bronchial asthma were consecutively selected from ear, nose and throat (ENT) and pediatrics cardiopulmonary outpatient clinics of Aminu Kano Teaching Hospital Kano respectively. Equal number of children aged 4 - 12 years with no history of ENT diseases or bronchial asthma that were selected from elementary schools within the same community served as a control group. An interviewer-administered questionnaire was filled out for all the participants, complete ENT and chest examinations were carried out and subsequently all the selected participants had tympanometry done, findings were recorded and analyzed. Results: The mean age of participants with bronchial asthma was found to be 7.5 ± 2.6 years while participants with allergic rhinitis had the mean age of 6.8 ± 2.1 years. The mean middle ear pressure (MEP) of participants with bronchial asthma was found to be -15.22 dapa and -40.32 dapa in those with allergic rhinitis. Acoustic reflex was found to be absent in 15.4% of the participants with bronchial asthma and 29.6% of allergic rhinitis participants. Type B tympanogram was found in 2.8% of bronchial asthma participants and 7.3% in participants with allergic rhinitis. Type C tympanogram was found in 4.6% of participants with bronchial asthma and 15.5% of participants with allergic rhinitis. Type A tympanogram was found in 90% of participants with bronchial asthma and 75% of participants with allergic rhinitis. The difference between type A, B and C tympanograms of participants with bronchial asthma and those with allergic rhinitis was found to be statistically significant (Type A χ2 = 14.62, df = 4, p value = 0.01, Type B χ2 = 14.06, df = 4, p value = 0.01, Type C χ2 = 17.01, df = 6, p value = 0.01). Conclusion: Participants with allergic rhinitis were found to have more abnormalities of tympanometric parameters compared to participants with bronchial asthma which signifies allergic rhinitis conferred an increased risk of having middle ear diseases and otitis media with effusion compared to bronchial asthma.

Allergic and nonallergic rhinitis in children: The role of nasal cytology

Nasal cytology is a diagnostic tool currently used in rhinology to study either allergic and vasomotor rhinological disorders or infectious and inflammatory rhinitis. Over the past few years nasal cytology has been rarely used in pediatrics, nevertheless its clinical and scientific applications seem to be very promising. The advantages of this technique are different: the ease of performance, the noninvasiveness allowing repetition and the low cost. We evaluated 100 children, from 2 to 15 years old, referred to our outpatient service for allergic children for suspected allergic rhinitis (AR). After skin prick test (SPT) or Radio Allergo Sorbent Test (RAST), 59/100 subjects were classified as affected by AR, while 8 children refused to be tested. According to ARIA guidelines, the 59 children with AR (4 - 15 years old) were divided in 56 with persistent AR and 3 with an intermittent form. Nine out of 59 children with AR had a significant number of neutrophils and eosinophils at the nasal cytology, documenting the presence of “minimal persistent inflammation”. Eleven out of 59 AR patients showed a positive swab for bacteria. Children with nonallergic rhinitis (NAR) were 33/100 (2 - 15 years old). After nasal cytology, 17/33 children were classified as NARES (nonallergic rhinitis with eosinophils), including one X-linked agammaglobulinemia (XLA) child, 1/33 as NARESMA (nonallergic rhinitis with eosinophils and mast cell) and another 1/33 as NARMA (nonallergic rhinitis with mast cell). In conclusion, nasal cytology allowed us to correctly classify children with NAR and to better assess the condition of children with AR.

Effect of tanshinone on blood coagulation, inflammatory factors and immune function in children with allergic purpura

Objective:To investigate the effects of tanshinone treatment on coagulation function, inflammatory factors and immune function in children with allergic purpura, and to guide clinical medication.Methods:130 children with allergic purpura diagnosed in a certain hospital from November 2015 to June 1818 were selected. According to the random number table method, they were divided into control group and study group, 65 cases in each group. The control group was given conventional anti-allergic drugs, and the study group was treated with tanshinone on the basis of the control group. The changes of renal function, inflammatory factors, coagulation function and immune function were compared between the two groups before and after treatment.Result:There were no significant differences in renal function, inflammatory factors, coagulation function and immune function between the two groups (P>0.05). After treatment, the levels of renal function Scr, BUN and Cysc and were significantly decreased in the two groups, and the inflammatory factors PCT, CRP levels were significantly decreased in the two groups (P<0.05). The above indexes of the study group were significantly lower than the control group (P<0.05). After treatment, APTT and PT levels were significantly increased in both groups, and FIB and ESR levels were significantly lower (P<0.05). The levels of APTT and PT in the study group were significantly higher than those in the control group, and the FIB and ESR level was significantly lower than that in the control group (P<0.05). After treatment, the levels of IgG, C3 and C4 were significantly lower in the two groups (P<0.05). The levels of IgG, C3 and C4 in the study group were significantly lower than those in the control group (P<0.05).Conclusion: Tanshinone combined with anti-allergic drugs has significant curative effects on children with Henoch-Schonlein purpura. It can significantly reduce renal function damage, alleviate inflammation stress response, improve coagulation function and correct immune disorders. And it is worthy of clinical application.

Application analysis of pidotimod in the treatment of allergic rhinitis in children accompanied by allergic asthma

Objective:To observe the application effect of pidotimod in the treatment of allergic rhinitis in children accompanied by allergic asthma.Methods:A total of 60 children with allergic rhinitis accompanied by allergic asthma who were admitted in our hospital from January, 2013 to January, 2015 were included in the study and randomized into the treatment group and the control group with 30 cases in each group. The patients in the two groups were given routine treatments in combined with sublingual immunotherapy. On this basis, the patients in the treatment group were given additional pidotimod. The immunological function, inflammatory cytokine level, and pulmonary function improvement in the two groups were observed. Results:The immunological function, inflammatory cytokine level, and pulmonary function improvement in the treatment group were significantly superior to those in the control group. Conclusions:Pidotimod can significantly enhance the immunological function in children with allergic rhinitis in children accompanied by allergic asthma, alleviate the inflammatory reaction, and promote the pulmonary function improvement, with an accurate efficacy.

匹多莫德辅助治疗小儿变应性鼻炎(allergic rhinits,AR)伴变应性哮喘的临床疗效

目的探究小儿变应性鼻炎(allergic rhinits,AR)伴哮喘应用匹多莫德的效果。方法按随机排列表法将2016年7月—2017年7月收入确诊的AR伴哮喘患儿80例分成对照组及观察组各40例,两组患儿予以常规护理治疗和舌下免疫治疗。对照组40例小儿入院后常规治疗,含服粉尘螨滴剂于舌下,观察组在对照组的基础上加用匹多莫德口服,治疗过程中密切观察两组小儿免疫功能改善情况。结果观察组患儿免疫功能优于对照组(P<0.05)。结论匹多莫德能显著提升哮喘患儿伴AR的自身免疫功能,疗效明显。

The Influence of Allergic Rhinitis Treatment on Asthma

Background: Rhinopathy, a dysfunction or inflammation of the nasal mucosal lining, presents with symptoms of nasal obstruction, posterior and anterior rhinorrhea, sneezing, nasal itching, and hyposmia, with variations in symptom intensity in each subtype. Asthma originates from a combination of genetic and environmental factors. Objective: This study aimed to treat allergic rhinitis in patients with controlled asthma and to verify the behavior of the variables. Methods: In this prospective study, quantitative and qualitative assessment of rhinopathy in asthma was performed. Patients with symptoms of rhinopathy and controlled asthma, who were controlled with treatment at the pulmonology outpatient clinic of the Center for Medical Specialties at [hospital], were included. Patients were treated for 2 months according to the IV Rhinopathy Consensus. They underwent a pulmonary function test and completed a questionnaire before and after treatment for rhinopathy. Results: In total, 47 patients aged 7 - 12 years (9.30 ± 1.70 years;median 9 years) were evaluated, including 29 (61.7%) males and 18 (38.3%) females. Patients were evaluated at two timepoints, with an interval of 12 days to 14 months (3.81 ± 3.21 months;median 3 months), and were evaluated regarding the various characteristics of their allergy. Conclusion: The treatment of allergic rhinitis in patients with asthma resulted in an improvement in variables related to nasal congestion, rhinorrhea, cough, dyspnea, wheezing, and dyspnea on exertion, and maintaining physical activities without dyspnea.

中医药防治儿童变应性鼻炎策略

变应性鼻炎是儿童常见过敏性疾病,其发病机制复杂,难以实现根治或有效且稳定的远期治疗目标。中医药防治儿童变应性鼻炎靶点广泛、作用持久且不良反应少,优势明显。提出变应性鼻炎发病多由肺脾肾三脏功能失调,外风引动伏风,两风相合而致。应采取发作期疏外风、抑伏风、宣肺利窍治其标,缓解期防外风、平伏风,调补肺脾肾治其本的中医药分期论治策略;同时应注重未病先防,包括避免先天禀赋因素的不良影响、避免后天环境因素的诱导发病、扶正御邪避其贼风,既病防变以及瘥后防复的全阶段预防。

呼出气一氧化氮、肺泡一氧化氮和嗜酸性粒细胞对3~6岁儿童呼吸系统疾病的鉴别诊断价值

目的探讨呼出气一氧化氮(FeNO)、肺泡一氧化氮(CaNO)和嗜酸性粒细胞(EOS)在甘肃省兰州市3~6岁儿童呼吸系统疾病鉴别诊断中的应用价值。方法选取确诊哮喘或过敏性鼻炎或下呼吸道感染的360例3~6岁儿童作为研究对象,采用斯皮尔曼秩相关系数评估FeNO、CaNO、EOS的相关性,通过随机森林模型、受试者工作特征(ROC)曲线、多因素逻辑回归分析评估FeNO、CaNO和EOS对3种疾病的鉴别诊断价值。结果哮喘患儿的FeNO、CaNO中位数高于其他疾病患儿,过敏性鼻炎患儿的EOS中位数最低,下呼吸道感染患儿的FeNO、CaNO中位数最低。相关性分析结果显示,FeNO与CaNO呈正相关(r=0.59,P<0.05),FeNO与EOS呈负相关(r=-0.61,P<0.05),CaNO与EOS呈负相关(r=-0.63,P<0.05)。随机森林模型显示,FeNO在疾病分类中的重要性最高。ROC曲线分析结果显示,3种疾病中,FeNO、CaNO、EOS对下呼吸道感染的诊断效能均最高(曲线下面积分别为0.86、0.91、1.00)。多因素逻辑回归模型诊断哮喘的曲线下面积为0.96,灵敏度为0.902,特异度为0.881。结论FeNO、CaNO和EOS在鉴别诊断兰州地区3~6岁儿童哮喘、过敏性鼻炎、下呼吸道感染方面展现出较好的潜力,且基于三者构建的多因素逻辑回归模型可有效提升对哮喘的诊断准确性。

益生菌对尘螨过敏性变应性鼻炎儿童的症状、药物使用及生活质量的影响

目的探讨益生菌对尘螨过敏性变应性鼻炎(AR)患儿的症状、药物使用及生活质量的影响。方法招募115例尘螨过敏性AR患儿作为研究对象,根据治疗方案的不同分为常规组(58例)和益生菌组(57例)。常规组采用常规治疗,益生菌组在常规组基础上给予益生菌干预。比较两组不同时间点[治疗前(T0)、治疗6个月后(T1)、停药6个月后(T2)]主观感受视觉模拟评分法(VAS)评分、用药评分、标准化鼻结膜炎生活质量调查问卷(RQLQ)评分、鼻部症状评分。结果常规组T0时VAS评分、用药评分、RQLQ评分分别为(5.97±2.01)、(1.64±1.06)、(2.04±0.72)分,T1时分别为(2.79±1.07)、(0.71±0.44)、(1.69±0.93)分,T2时分别为(2.48±0.99)、(0.58±0.49)、(1.71±0.93)分;益生菌组T0时VAS评分、用药评分、RQLQ评分分别为(6.18±1.94)、(1.71±1.09)、(2.01±0.73)分,T1时分别为(2.05±0.78)、(0.49±0.45)、(1.37±0.67)分,T2时分别为(2.21±0.81)、(0.54±0.45)、(1.58±0.72)分。两组T1和T2时VAS评分、用药评分、RQLQ评分均较T0时降低,益生菌组T1时VAS评分、用药评分、RQLQ评分均低于常规组,差异有统计学意义(P<0.05);T0、T2时两组VAS评分、用药评分、RQLQ评分无明显差异(P>0.05)。常规组T0时鼻塞、鼻痒、喷嚏、流涕评分分别为(1.81±0.66)、(1.60±0.62)、(1.68±0.77)、(1.34±0.69)分,T1时分别为(0.95±0.53)、(0.87±0.49)、(0.90±0.56)、(0.96±0.46)分,T2时分别为(0.93±0.54)、(0.84±0.43)、(0.88±0.31)、(0.89±0.54)分;益生菌组T0时鼻塞、鼻痒、喷嚏、流涕评分分别为(1.78±0.57)、(1.63±0.61)、(1.70±0.70)、(1.41±0.69)分,T1时分别为(0.75±0.45)、(0.72±0.23)、(0.70±0.43)、(0.78±0.50)分,T2时分别为(0.91±0.43)、(0.83±0.51)、(0.86±0.53)、(0.85±0.50)分;两组T1和T2时鼻塞、鼻痒、喷嚏、流涕评分均较T0时降低,益生菌组T1时低于常规组,差异有统计学意义(P<0.05);T0、T2时两组鼻塞、鼻痒、喷嚏、流涕评分无明显差异(P>0.05)。结论尘螨过敏性AR患儿口服益生菌,可有利于减轻患儿症状,改善患儿生活质量,减少临床药物的使用,且具有时间依赖性。

以麻黄为主药系列经方在儿童过敏性疾病辨治中的运用

以麻黄为主药系列经方在儿童过敏性疾病辨治中的运用。儿童过敏性疾病多年来是临床治疗的难点,以麻黄为主药系列方治疗该病临床疗效确切肯定。儿童过敏性疾病多因正气不足,肺、脾、肾功能低下,痰饮等伏邪宿根停留于体内,外邪引动而发病。麻黄为治疗咳喘之圣药,通过合理的配伍,麻黄与杏仁宣降相成,麻黄与石膏寒温并举,麻黄与附子温通表里。为了确保疗效,要重视遵循经方的原配伍比例、剂量、组方、煎服法和调护法。此外,还要明确麻黄类方及方证应用,即对方证,抓主证。

儿童过敏性鼻炎伴食物过敏原检测阳性的临床特征分析

目的总结过敏性鼻炎(AR)伴食物过敏原检测阳性患儿的临床特征,为制订AR儿童的饮食及营养方案提供依据。方法本研究为回顾性分析,选取2021年1月至2022年12月于首都医科大学附属北京同仁医院变态反应科就诊的330例AR伴食物过敏原检测阳性患儿为研究对象。收集患儿血清过敏原检测结果,包括血清总免疫球蛋白E(IgE)以及13种食物过敏原的血清特异性免疫球蛋白E(sIgE),分析其临床特征和食物过敏原分布特点。结果330例AR伴食物过敏原检测阳性患儿中男性209例(63.33%),女性121例(36.67%);中位就诊年龄5岁,按年龄进行分组,其中<3岁组17例,3~<6岁组155例和≥6岁组158例,年龄≥6岁患儿占比最高(47.88%)。血清总IgE为4~4674 kUA/L,中位数167 kUA/L,其中检测结果升高者(≥60 kUA/L)占78.18%。99例患儿吸入性过敏原筛查阴性,231例患儿吸入性过敏原筛查阳性,吸入性过敏原筛查阴性患儿的血清总IgE升高比例(51.52%)低于吸入性过敏原筛查阳性患儿(89.61%),差异有统计学意义(P<0.05);不同年龄患儿血清总IgE升高比例比较差异有统计学意义(P<0.05),≥6岁组血清总IgE升高比例最高(51.94%),其次是3~<6岁组(42.64%)。食物过敏原阳性检出率最高的3种食物分别是牛奶(72.42%)、蛋清/蛋白(22.42%)和水果类(13.94%);对不同年龄、性别患儿的食物过敏原分布进行比较,结果显示女性患儿的蛋清/蛋白阳性率高于男性,蛋清/蛋白阳性率在<3岁年龄患儿中最高,其次是3~<6岁,最低的是≥6岁,差异均有统计学意义(P<0.05)。结论儿童AR伴食物过敏原检测阳性以男性患儿更为多见,牛奶、蛋清/蛋白及水果类为主要食物过敏原,且女性患儿及年龄<3岁患儿的蛋清/蛋白阳性率最高。

托珠单抗注射液致过敏性休克1例分析

目的 分析托珠单抗注射液致过敏性休克的特点,为临床合理用药提供参考。方法 报道1例儿童使用托珠单抗导致过敏性休克的案例,通过文献回顾托珠单抗导致过敏性休克的情况,并分析原因及防治措施。结果 根据患者的临床表现及药物与用药时间的关联性,考虑托珠单抗导致过敏性休克,患者经有效抗过敏治疗后,过敏性休克症状得到缓解。结论 临床应用托珠单抗应警惕过敏性休克等过敏情况,对严重过敏患者应禁止使用。

三伏天联合三九天中药穴位敷贴治疗儿童肺气虚寒型常年性变应性鼻炎临床研究

目的探讨三伏天联合三九天中药穴位敷贴治疗儿童肺气虚寒型变应性鼻炎的临床疗效。方法选择选取2021年1月至2022年12月就诊的90例肺气虚寒型儿童变应性鼻炎患者,随机分为敷贴组、药物组和安慰组,每组30例。比较三组治疗前后的鼻部症状评分、鼻腔体征评分及总有效率。结果敷贴组鼻部症状、鼻腔体征评分均下降,且优于药物组及安慰组(P<0.05),敷贴组中医疗效总有效率显著高于药物组和安慰组(P<0.05)。结论三伏天联合三九天中药穴位敷贴可显著改善儿童肺气虚寒型变应性鼻炎症状,提高临床疗效,值得临床推广应用。

重庆地区近10年住宅环境因素与儿童过敏性疾病的关联变化

基于2010年和2019年重庆地区住宅环境与儿童健康重复大样本横断面调研数据,采用二元logistic回归对比分析了10年前后住宅环境因素与儿童过敏性疾病的关联变化。结果显示:与10年前相比,很多与儿童过敏性疾病显著相关的因素在10年后并未呈现显著性,如住宅位置、住宅建筑类型、住宅建筑面积、怀孕期间重新装修、卫生间安装有机械通风设备;部分对儿童过敏性疾病无显著影响的因素在10年后调研中显著增加了儿童过敏性疾病患病风险,如室内购置新家具、住宅周边环境为工业区、儿童卧室墙壁材料使用乳胶漆(与石灰、水泥相比);10年后住宅周边环境为商业区不再显著增加儿童成长期患过敏性鼻炎和现患鼻炎症状的风险,但会显著增加儿童成长期患湿疹的风险,而夜晚降低儿童卧室通风频率降低了儿童患过敏性疾病的风险。研究结果可为认识住宅环境变化对儿童过敏性疾病影响的关联关系及改善儿童住宅居住环境提供一定的指导和参考。

高频超声在儿童腹型过敏性紫癜的诊断价值及声像图特征分析

目的应用高频超声分析对儿童腹型过敏性紫癜的诊断价值及声像图特征。方法研究对象为2020年8月至2023年8月于我院收治的92例腹型过敏性紫癜患儿,患儿入院后均行高频超声检查,通过探头对患儿肠壁肠管情况、回声及肠壁血供等进行探查,分析声像图特征。根据大便隐血试验结果将患儿分为消化道出血组(51例)和无消化道出血组(41例),对比2组患儿影像学特征中肠壁增厚情况,进一步分析高频超声的诊断价值。结果92例患儿中,76例(83%)患儿具有特异性声像图特征,表现为肠壁存在程度不一的厚度增加,以节段性、广泛性为主要特征,肠壁回声降低,小肠为主要病变位置,黏膜下层的厚度明显增加,短轴变化明显,横切时呈“面包圈”征,纵切时呈“玉米”征;彩色多普勒超声血流显像(CDFI)结果显示,相较于正常肠壁,厚度增加的肠壁的血流信号增多。92例患儿中,盆腹腔积液及肠套叠的例数分别为18例和2例,多数患儿伴有肠系膜淋巴结增大表现。比较2组患儿肠壁增厚情况,消化道出血患儿发生率更高(P<0.05)。结论高频超声在儿童腹型过敏性紫癜的诊断中具有较高的应用价值,声像图特征较为典型,能够有效探查腹腔肠壁情况,且具有无创、可重复性等优势,患儿及家属接受度高,具有一定应用价值。

成都市天府新区变应性鼻炎患儿变应原分布情况及影响因素分析

目的:分析成都天府新区变应性鼻炎(AR)患儿变应原类型及影响因素,为儿童AR防治提供依据。方法:选取2020年1月—2023年6月就诊于成都市第七人民医院天府院区、成都市双流区第一人民医院、成都天府新区华阳社区卫生服务中心的AR患儿300例为观察组,另选择同期于上述医院就诊的非AR儿童80例为对照组。分析AR患儿变应原分布情况,采用多因素Logistic回归分析儿童患AR的影响因素。结果:学龄前组变应原阳性率前3位分别是蛋清/蛋黄、牛奶和尘螨/粉螨,学龄组变应原阳性率前3位分别是尘螨/粉螨、蛋清/蛋黄、牛奶。观察组患儿有家族史、有过敏史、饲养宠物、患支气管哮喘、无母乳喂养率高于对照组(P<0.05)。Logistic多因素回归分析显示,家族史、过敏史、饲养宠物、合并支气管哮喘是儿童患AR的危险因素,母乳喂养是其保护因素(P<0.05)。结论:成都天府新区AR患儿主要吸入性变应原为屋尘、尘螨/粉螨、霉菌,主要食入性变应原为蛋清/蛋黄、牛奶、鳕鱼/鲑鱼/鲈鱼。家族史、过敏史、合并支气管哮喘、饲养宠物是儿童AR的独立危险因素,母乳喂养是保护因素。临床应根据上述情况进行针对性干预。

中药外用制剂在儿童变应性鼻炎中的应用及思考

变应性鼻炎是儿童常见的变态反应性疾病之一,全球高发且发病率逐年增高,无法根治且易反复发作,给患儿及其家庭带来很大的困扰和负担。中药外用制剂作为行之有效的治疗方法,尤其适合儿科临床应用。笔者通过检索数据库中关于应用中药外用制剂治疗儿童变应性鼻炎的临床及实验研究,总结了其临床应用及可能发挥作用的机制,并分析了当前中药外用制剂治疗该病的优势及问题,以期为儿童变应性鼻炎临床诊疗及研究方向临床提供一定参考。

丙酸氟替卡松联合孟鲁司特在儿童支气管哮喘合并变应性鼻炎治疗中的价值研究

目的探讨于儿童支气管哮喘合并变应性鼻炎患儿中应用丙酸氟替卡松联合孟鲁司特治疗的临床效果。方法选取支气管哮喘合并变应性鼻炎患儿60例,选择随机数字表法分为对照组和观察组,各30例。对照组实施丙酸氟替卡松治疗,观察组应用丙酸氟替卡松联合孟鲁司特治疗。比较两组临床治疗效果,肺功能指标(用力肺活量、呼气峰值流速、第1秒用力呼气容积),哮喘症状和鼻炎症状评分,炎症因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]水平,不良反应发生情况。结果①观察组治疗总有效率为96.67%,高于对照组的73.33%(P<0.05)。②治疗后,两组用力肺活量、呼气峰值流速、第1秒用力呼气容积均升高,且观察组用力肺活量(3.99±1.03)L、呼气峰值流速(172.32±27.53)L/min、第1秒用力呼气容积(2.64±0.62)L高于对照组的(3.36±0.97)L、(154.37±27.42)L/min、(1.97±0.56)L,差异显著(P<0.05)。③治疗后,两组哮喘症状和鼻炎症状评分均降低,且观察组哮喘症状评分(4.93±1.96)分和鼻炎症状评分(3.52±1.27)分低于对照组的(6.60±2.22)、(4.21±1.38)分,差异显著(P<0.05)。④治疗后,两组IL-6和TNF-α水平均降低,且观察组IL-6(93.80±23.63)ng/L和TNF-α(313.51±37.16)ng/L低于对照组的(109.49±26.38)、(351.40±46.38)ng/L,差异显著(P<0.05)。⑤两组不良反应发生率比较,无显著差异(P>0.05)。结论支气管哮喘合并变应性鼻炎患儿应用丙酸氟替卡松联合孟鲁司特治疗的临床效果突出显著,不仅能够有效改善患儿的哮喘症状和鼻炎症状,同时可改善患儿肺功能和炎症因子水平,建议广泛应用于临床治疗中。